Auditory Discrimination Training for the Treatment of Tinnitus

International Archives of Otorhinolaryngology, 2020

Introduction Research with tinnitus patients presenting with hearing loss and normal hearing subjects have verified that tinnitus interferes with auditory processing. One treatment option for this symptom consists of tinnitus habituation therapy. Objective To determine the influence of tinnitus habituation therapy on auditory abilities, on the self-perception of tinnitus regarding loudness and discomfort, and its impact on the quality of life. Methods A quasi-experimental study was conducted with 19 individuals with tinnitus. Audiological tinnitus and auditory processing evaluations were performed. Subsequently, the volunteers underwent tinnitus habituation therapy for 6 months. Ultimately, all of the individuals were reevaluated. Results A statistically significant reduction in tinnitus self-perception was observed in relation to loudness, discomfort, and its impact on the quality of life (p 0.001, 0.001, 0.023, respectively). However, the influence of tinnitus habituation therapy on auditory abilities was not verified. Conclusion Tinnitus habituation therapy was effective in reducing the self-perception of tinnitus loudness and discomfort, as well as the impact of the symptom on the quality of life. However, these factors did not improve the auditory processing skills in tinnitus patients.

Annals of Behavioral Medicine, 2010

Auditory perceptual training affects neural plasticity and so represents a potential strategy for tinnitus management. We assessed the effects of auditory perceptual training on tinnitus perception and/or its intrusiveness via a systematic review of published literature. An electronic database search using the keywords 'tinnitus and learning' or 'tinnitus and training' was conducted, updated by a hand search. The ten studies identified were reviewed independently by two reviewers, data were extracted, study quality was assessed according to a number of specific criteria and the information was synthesised using a narrative approach. Nine out of the ten studies reported some significant change in either self-reported or psychoacoustic outcome measures after auditory training. However, all studies were quality rated as providing low or moderate levels of evidence for an effect. We identify a need for appropriately randomised and controlled studies that will generate high-quality unbiased and generalisable evidence to ascertain whether or not auditory perceptual training has a clinically relevant effect on tinnitus.

The international tinnitus journal, 2010

The aim of the study is to present our results regarding the efficacy of TRT for tinnitus relief in patients with clinically significant tinnitus compared to a group treated with vasoactive agents. In a nonrandomized prospective study, 63 patients with disabling tinnitus were recruited. Greek translation of the Tinnitus Handicap Inventory (THI) and visual analogue scale (VAS) for annoyance caused by tinnitus when conducting four major activities of everyday life (work, sleep, relaxation and concentration) were examined in a 12-month period. The THI score was significantly improved in the TRT group, as well as mean VAS scores, in all measures. Comparison of the mean improvement of THI and VAS scores after treatment showed significant differences between the two groups, favoring TRT treatment. Our data suggest that TRT is an effective treatment. It reduces the level of annoyance induced by tinnitus and improves the ability of patients to work, sleep, relax or be concentrated.

Journal of The American Academy of Audiology, 2019

Background: It is well accepted among clinicians that maskers and hearing aids combined with counseling are generally helpful to tinnitus patients, but there are few controlled studies exploring the efficacy of maskers alone to decrease the prominence of tinnitus. Purpose: We investigated the benefit of maskers for patients with chronic, bothersome tinnitus. Research Design: Crossover single-participant design, where each participant served as their own control. Study Sample: 18 adults with subjective, nonpulsatile, sensorineural tinnitus. Intervention: Participants participated in two six-week trials: one with sound therapy and one without. No counseling was provided in either group. Masking devices were fit with sounds intended to reduce the tinnitus prominence. Data Collection and Analysis: Participants rated tinnitus loudness, tinnitus annoyance, and acceptability of the background sounds using a numeric 0-100 interval scale and completed the Tinnitus Primary Functions Questionnaire (TPFQ). Results: Three participants dropped out. On the total score of the TPFQ, 5 of 15 remaining participants (33%) showed a benefit. Using a derived score based on functions showing a handicap before the study, maskers benefit was observed in the areas of sleep (five of nine), hearing (three of eight), thoughts and emotions (three of four), and concentration (four of eight). The TPFQ and annoyance data complemented each other well. Conclusions: This study demonstrates the benefit of partial masking, encouraging patients to seek help from audiologists interested in providing support for tinnitus patients.

Psychosomatic Medicine, 2005

Background: Tinnitus seems to be associated with psychophysiological over-activation (e.g., of head and shoulder muscles). Therefore we aimed to develop and evaluate a new intervention program including a psychophysiological approach. Methods: Forty-three tinnitus sufferers were randomized to 2 groups, one receiving a psychophysiologically oriented intervention lasting 7 intervention sessions (plus 2 assessment sessions), whereas the other group waited for a comparable time period. Afterward, patients on the waiting list also received the intervention. Physiological variables were muscle activity of head and shoulders and electrodermal activity. Psychological assessments took place at pretreatment, post-treatment, and 6 months later. Follow-up data were available from 95% of participants. Major outcome variables were self-rating scales (e.g., tinnitus annoyance assessed by the Tinnitus Questionnaire), and diary data (self-control, daily time of perceiving the tinnitus). Results: On most tinnitus specific variables, patients in the treatment group improved significantly more than patients on the waiting list. Main effect sizes for tinnitus-specific variables were up to 0.89. Muscle reactivity of head muscles at the beginning predicted significant treatment effects. Conclusion: Compared with meta-analytical reviews of psychological interventions for tinnitus sufferers, the presented treatment is brief and in the upper range of effectiveness.

Journal of Recent Advances in Medicine (Print), 2023

Background: Severe tinnitus causes many, often psychological symptoms (e.g., tension, frustration, impaired concentration, disrupted sleep). Tinnitus sufferers may benefit from cognitive behavioural therapy (CBT), which has been shown useful. Objective: to assess whether cognitive behavioural therapy is effective in management of patients suffering from tinnitus. Methodology: It was Randomized controlled clinical trial (RCT) that was conducted in Audio-vestibular units and psychiatric departments at Al-Zahraa university Hospital and Banha Educational Hospital. The study consisted of 60 participants, were divided into 2 groups: Group (1): study group: 30 tinnitus cases receiving CBT over 8 weeks, only 22 patients had complete sessions and the other refused completing sessions because they were not interested. Their mean age was (46.23 ± 13.98). They were 10 males (45.5%) and 12 females were (40.0%). Group (2): waitlist control group: 30 control subjects , their mean age (48.43 ± 13.64). They were 12 male (54.5%) and 18 female 60.0%). Basic audiological evaluation by using Pure tone audiometry(PTA) , tympanometry, speech audiometry and Psychophysical parameters (Tinnitus pitch • tinnitus loudness), Questionnaires (Tinnitus handicap inventory (Arabic version)General health questionnaire (GHQ). Beck depression inventory. PCASEE Quality of life questionnaire). Results: Study group showed significant improvement of tinnitus related symptoms after intervention when compared to control group evidenced by improvement in GHQ, BDI, PCASEE scores when compared to control group. Otherwise, no significant difference was found regarding THI score between the two groups. Conclusion: Cognitive behavioural therapy (CBT) could be effective in reducing the impact of tinnitus on quality of life evidenced by improvement in PCASEE Quality of life scores. Nevertheless, we are fully aware that the sample size is too small to draw a definitive conclusion out of our study.

The Journal of Rehabilitation Research and Development, 2005

Chronic tinnitus is experienced by 10%-15% of the population, of which only about 20% require clinical intervention. People requiring intervention have different levels of need, ranging from the provision of basic information to long-term, individualized treatment. We address this clinical need by outlining a five-level "progressive intervention" approach to the management of tinnitus that would provide a systematic framework for treatment by audiologists. At each level, patients must be appropriately referred-usually to otolaryngology, psychology, and/or psychiatry. Level 1 is an interview method of screening for determining if the person requires clinical intervention (and addressing basic questions). Level 2 is the provision of structured group educational counseling. If the screening determines that care is urgently required or if further help is needed following the group session(s), a tinnitus intake assessment (Level 3) should be performed. The intake assessment, wh...

Ear and hearing, 2016

In this four-site clinical trial, we evaluated whether tinnitus masking (TM) and tinnitus retraining therapy (TRT) decreased tinnitus severity more than the two control groups: an attention-control group that received tinnitus educational counseling (and hearing aids if needed; TED), and a 6-month-wait-list control (WLC) group. The authors hypothesized that, over the first 6 months of treatment, TM and TRT would decrease tinnitus severity in Veterans relative to TED and WLC, and that TED would decrease tinnitus severity relative to WLC. The authors also hypothesized that, over 18 months of treatment, TM and TRT would decrease tinnitus severity relative to TED. Treatment effectiveness was hypothesized not to be different across the four sites. Across four Veterans affairs medical center sites, N = 148 qualifying Veterans who experienced sufficiently bothersome tinnitus were randomized into one of the four groups. The 115 Veterans assigned to TM (n = 42), TRT (n = 34), and TED (n = 39...

Rehabilitation Psychology, 2009

Objectives: To explore the effects of a new tinnitus treatment program (tinnitus intensive therapy [TIT]) based on auditory perception principles and neural habituation. Methods: A follow-up study with measurement of treatment effects every third month over a 2-year period in which the cases were their own controls. Participants: There were 25 participants with a mean age 50.1 years (SD ϭ 16.1); 10 women (52.7 years; SD ϭ 16.8) and 15 men (48.3 years; SD ϭ 15.9). The participants were recruited from clinical population admitted to a polyclinic tinnitus treatment program in western Germany. Results: There was a significant reduction of tinnitus in the follow-up period. Mean baseline tinnitus scores (Tinnitus Fragebogen; Goebel & Hiller, 1998) at the start of the treatment were 50.9 (SD ϭ 14.5) and the final scores were 14.2 (SD ϭ 5.9). In total, the clinical improvement over the follow-up period was 72.1%. Conclusion: The TIT program showed a significant clinical treatment effect and should be tested further in a multicenter treatment project. The findings support the Jastreboff habituation model of tinnitus, but social cognitive factors should also be taken into account.

BMC Ear, Nose and Throat Disorders, 2009

Background: Tinnitus impairs the possibility of leading a normal life in 0.5-1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC) in southern Denmark. The aims of this exploratory study were to examine i) the characteristics of CHC's clients and their tinnitus, ii) the effectiveness of the treatment, and iii) whether particular client groups benefit more than others. Methods: One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI) three times-before their first consultation, after one month and after 1-2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points). Results: At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5-34.2) vs. 37.2 (CI 33.1-37.2), p < 0.01. The programme achieved a clinically important difference for 27% and 24% of the clients one month and 1-2 years after the first consultation, respectively. It appeared that greater improvement in THI score was related to higher baseline THI score and possibly also to treatment by a particular CHC therapist. The absolute reduction in mean THI score after 1-2 years for clients with moderate and severe handicap was 14 and 20 points, respectively, i.e. similar to that previously reported for TRT (14-28 points). The cost of the current programme was approximately 200 EUR per client. Conclusion: The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches.